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General NPI Number Information
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NPI Number | 1053723379
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Entity Type | Organization
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Legal Business Name | LIFE INTENSITY COUNSELING SERVICES
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Dates
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Enumeration Date | 05/21/2014
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 9300 JOHN HICKMAN PKWY STE 801
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City | FRISCO
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State | TX
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Zip | 75035-5913
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Country | US
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Telephone | 817-404-4492
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Fax |
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Provider Business Mailing Address
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Address Line | 9300 JOHN HICKMAN PKWY STE 801
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City | FRISCO
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State | TX
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Zip | 75035-5913
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Country | US
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Telephone | 469-441-6163
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Fax | 469-405-6565
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MONICA RENEA GRAY
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Credential | LCSW
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Telephone | 817-618-6001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 50478
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License Number State | TX
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